Our long-term goal is to develop an inexpensive, simple, portable means of screening for oral cancer in the field by basic level healthcare workers in low-resource environments. Screening will identify whether a person needs to travel to a center with higher levels of expertise in oral cancer for further tests and potential cancer therapy. The objective of this application is to re- engineer existing technology to provide an inexpensive very small, robust portable diagnostic system for oral cancer based on Optical Coherence Tomography (OCT) and a simple diagnostic algorithm that indicates further diagnostic and treatment needs for each individual. Briefly, under the first Specific Aim a robust portable diagnostic system for oral cancer based on Optical Coherence Tomography (OCT) will be constructed and undergo clinical testing at the university of California, Irvine. Under Specific Aim 2, the mini-OCT device and a simple diagnostic algorithm will be tested in India in a specialty Head and Neck Cancer Clinic, and by low-level healthcare workers in the field. The proposed collaborative work between researchers at the University of California Irvine and the Mazumdar-Shaw Cancer Center in Bangalore is directly responsive to PAR 11-044 as the proposed device will provide point-of-care cancer screening by basic level healthcare workers. The low-cost, portable, robust imaging system will have the potential for integration into a networked mobile diagnostic network. Relevance. Annually 275,000 oral cancers (OC) and 125,000 deaths due to OC occur worldwide, and OC accounts for up to 50% of cancer cases in India. Because over 2/3 of OC lesions are detected late, treatment outcomes and prognoses are extremely poor. Currently there exists no portable, low-cost, robust, inexpensive simple means of screening for oral cancer in the field by basic-level healthcare workers. We propose to develop and validate a diagnostic modality that will overcome this critical barrier to widespread screening of high-risk populations in low-resource environments. The low-cost, portable end product will provide the basis for future networked and mobile technology for remote cancer diagnostics via minimally educated healthcare workers in the field. PUBLIC HEALTH RELEVANCE: Annually 275,000 oral cancers (OC) and 125,000 deaths due to OC occur worldwide, and 2/3 of OC lesions are detected late when treatment prognoses are extremely poor. There exists no portable, low-cost, simple means of screening for oral cancer. We propose to develop and validate a diagnostic modality for widespread screening of high-risk populations in low-resource environments that will provide the basis for future networked and mobile technology for remote cancer diagnostics via minimally educated healthcare workers in the field.